aculberg

I called Triwest to see if Colledge was a network provider, and she isnt! Dang it! They did give me a list of providers that are, but I dont know if the surgeon's office will allow me to go to another psych for the eval. I guess I should try to contact them yet again, which is a pain!! And if the criteria is the same for Tricare Prime and Standard as far as qualifying for the surgery, then I guess I'll stick with Prime and just cross my fingers! Thanks so much for all your input.

Ok, so youre going with Tricare Standard, right? Have you figured out what your total costs will be? Also a big question for me is, with Standard, can you just have the surgery done, or does Tricare still have to approve it with the 100lbs overweight and co-morbids?? I have Tricare Prime and am nervous that they wont approve me b/c I am so close to the 100 lbs! I'm wondering if I switch to Standard, I know there would be some out of pocket, but hey, I'm already looking at $675 if insurance covers it anyways, with the psych eval and the $500 program fee!! If I dont have to jump through hoops with Standard, I'm switching!! lol

Choromom - I think I talked to you on another post! I have my initial consult scheduled for 6/25/08, youre also trying to go through Tricare, right?? So, how did your consult go? I know you said she's nice, thats who I decided to go with, I met Dr. Cottam at the seminar, but went with Richards in the end. What all did they do at your first appt? I am so nervous, and just hoping they really try everything to get insurance approval...did you have any experience with that? I really hope everything goes well for you, keep me updated and thanks for answering all my ???'s :biggrin: Oh also, did you have to pay for your psych consult, or were you able to get Tricare to cover that? They told me I would have to pay $175 for that on my initial consultation...

Choromom ~ I see youre in Utah, me too, were stationed up at Hill AFB. What surgeon are you working with? I just got my referral to SL Regional with Dr Cottam and Dr Richards. My referral was approved last nt, but when I called the surgeons office today, I couldnt get a hold of them to make an appt!!:wink2: As far as Standard goes, I think you pay up to $1000, thats your max deductible for the year, then they pay everything else. But I'm not 100% on that one, you may wanna call them and ask. I've heard that with a network provider you pay 15% they pay 85%, up to that max of $1000. But check it out, and let me know what docs youre going with! Good luck!

Ok, so I have a question about adding a little weight to qualify. I am at that mark, just got approval from my pcm to see the surgeon. So at the first surgeon visit, would it be terrible to wear ankle weights? I mean, do they check?? I would be horrified if they did. Also, what all happens at that first appt??:confused: Take me step by step!! lol

You took the question right outta my mouth!! I just saw my pcm this morning and he submitted the referral for the surgeon. So my question is, when I get the authorization, and go in for the surgeons initial consultation, what should I expect? What kind of exam is it, etc? I do get to leave my clothes on??!! Any info on this would be great, as I'm so nervous on what to expect next!

Tori2003 ~ I am pretty much in the same situation, and was wondering if you got approved through Tricare? I am 5'5" and weigh about 228lbs. Do you have other co-morbidities that would help you get approved? I too am soo anxious and nervous, and wondering if I will get the approval, I want it so badly!! Thanks for any info!

Hi there, I too am trying to get approved through Tricare for the lapband. I had to change my pcm from on base to off base b/c the doc on base was completely uncooperative! I have gone to the lapband seminar and they say you do have to have a referral from your pcm to get started. So, thats where I'm at, waiting for Tricare to update my pcm so I can go and see him and get the referral. I am kinda nervous about getting approved because I am probably just below (within 10 lbs) of being 100 lbs over. I do have hypothyroidism (slow thyroid) and some knee joint issues and I heard from the surgeons nurse that if you have urinary incontinence, thats also a condition?! So, sounds like were all in the beginning stages of getting approval, nice to know I'm not alone!! Good luck and lets keep each other posted!

harleygirl, thank you so much for the info on the docs, did SL regional make you go through any kind of special diets, etc before you had the surgery? I have heard of some of them making you wait 6 months...I hope not!

Thanks so much! I think I will make another appt to see another PCM on base, maybe a civilian doc, as I think they arent so strict. I'm wondering if I contact a wls center, if they'll give me the names of some supportive pcm's that have a history of referring?! I really want to get this going, I do have a seminar scheduled for May 13, which cant come soon enough! lol

Hi everyone, were stationed at Hill up in Layton. Just wondering if anyone can recommend a good primary physician that will approve the surgery, or if anyone has Tricare, who did they go through to get approval. Also, I'm looking for a good surgeon/surgical center. I am attending the seminar in Ogden for Salt Lake Regional hospital, is that a good one? Any info on docs and referrals would be great!!

Stay tuned ~ what base are you at? I also am under TriWest, stationed at Hill AFB, UT. Went to see my PCM and she was all about the diet and exercise way to go, even tho I've tried all that. Needless to say, she wasnt supportive at all! So, now I'm looking for a PCM that will approve my request either on or off base...wish me luck!!

minpinmom ~ We love it here too, but weve been here forever (8yrs) and were ready for a change! Where are you at now? How did you get your pcm to approve the surgery?? So many questions....:rolleyes2:

I had the same thing happen to me, were stationed at Hill AFB in Utah, and I went in and spoke to my PCM and she was all about exercising everyday, etc etc, even though I've tried almost everything! I think I am on the borderline of not being approved b/c I'm not "heavy" enough! To me, I am!! So, my question is, does anyone know of a good PCM, on or off base here in UT that would approve it? Or can I go to the lapband doc and they can approve it?? Does anyone know what the requirements are? I am 5'5" and weigh 229 with a 38 bmi. I have hypothyroidism, and lately elevated blood pressure. I have been going to a medical weight loss clinic for over a year now, and paying out of pocket, which gets way expensive. I was down to 206 going there, but then life takes over and here I am! Any info and suggestions would be great!!